There are large numbers of patients suffering from gastro-intestinal symptoms referrable to the lower small bowel and large bowel which to date have eluded explanation. These disorders include irritable bowel syndrome (IBS) or spastic colon, idiopathic ulcerative colitis, mucous colitis, collagenous colitis, Crohn's disease, inflammatory bowel disease in general, microscopic colitis, antibiotic-associated colitis, idiopathic or simple constipation, diverticular disease, and AIDS enteropathy. Pathophysiology of these disorders eludes logical explanation in spite of decades of research and millions of dollars of research funds. A common underlying factor shared by all these disorders observed by the present inventor is their onset following some extraneous invading infection. In all the disorders, the infection cannot be demonstrated due to our inability to detect infecting agents whose cultural characteristics are unknown to medical science.
Circumstantial evidence which suggests that these disorders are "infection-related" includes:
(a) onset following a gastro-intestinal infection which failed to completely resolve; PA1 (b) transient improvement with use of certain antibiotics, but recurrence upon cessation of antibiotics; PA1 (c) transient improvement following orthostatic lavage prior to colonoscopy and; PA1 (d) transient symptom improvement with use of "colonic" irrigation. PA1 i) gastro-intestinal disorders including irritable bowel syndrome or spastic colon, ulcerative colitis, mucous colitis, collagenous colitis, Crohn's disease, inflammatory bowel disease, microscopic colitis, antibiotic associated colitis, idiopathic or simple constipation, diverticular disease, AIDS enteropathy, small bowel bacterial overgrowth, coeliac disease, polyposis coli, colonic polyps, chronic idiopathic pseudo obstructive syndrome; PA1 ii) chronic gut infections with specific pathogens including bacteria, viruses, fungi and protozoa; PA1 iii) liver disorders such as primary biliary cirrhosis, primary sclerosing cholangitis, fatty liver or cryptogenic cirrhosis; PA1 iv) joint disorders such as rheumatoid arthritis, non-rheumatoid arthritidies, ankylosing spondylitis, and Reiter's syndrome; PA1 v) immune mediated disorders such as glomerulonephritis, haemolytic uraemic syndrome, juvenile diabetes mellitus, mixed cryoglobulinaemia, polyarteritis, familial Mediterranean fever, amyloidosis, scleroderma, systemic lupus erythematosus, and Behcet's syndrome; PA1 vi) neurological syndromes such as migraine, multiple sclerosis, amyotrophic lateral sclerosis, myasthenia gravis, chronic fatigue syndrome, Parkinson's disease, Alzheimers disease and other degenerative disorders; PA1 vii) dermatological conditions such as, chronic urticaria, acne, dermatitis herpetiformis and vasculitic disorders; PA1 (a) substantially complete removal of existing enteric flora, and PA1 (b) introduction of an array of predetermined flora into the gastro-intestinal system, and thus in a preferred form the method of treatment comprises substantially completely changing enteric flora in patients requiring such treatment. PA1 i) an enema composition which can be reconstituted with an appropriate diluent; PA1 ii) enteric-coated capsules, or PA1 iii) powder for reconstitution with an appropriate diluent for naso-enteric infusion or colonoscopic infusion, or PA1 iv) powder for reconstitution with appropriate diluent, flavouring and gastric acid suppression agent for oral ingestion.
It is impractical to use long-term antibiotic therapy (with its associated complications) in such patients since cure is not obtained with its use. Furthermore, chronic gut infections with recognised, specific pathogens such as Clostridium difficile, Yersinia enterocolitica or Campylobacter jejuni/coli are not eradicated with antibiotics. Some previous attempts have been made to alter the enteric microflora in order to eradicate such chronic infections. These measures nevertheless indicate that alteration of bacterial flora may effect dramatic clinical improvement in conditions characterized by chronic, resistant enterocolitic infection. However there remain many chronic disorders of uncertain aetiology or causation, which are resistant to cure by current therapeutic techniques.